Conditions

Symptoms and Naturopathic Treatments for PANDAS and PANS: Everything You Need to Know

November 10, 2021

I’m Dr. Lindsay
I'm a naturopathic pediatrician based in Colorado Springs offering primary care, chronic care & telemedicine appointments. I'm so glad you're here!
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We pray for our children to be healthy every day since before our darlings were born into the world. It’s every parent’s deepest wish. Parenting a sick child is hard. Not only because we feel fear and anxiety for our child’s well-being, although this alone is extremely painful, but because it can also feel incredibly lonely. Parents of a child with PANDAS/PANS often experience this to a devastating extent.

Unlike common childhood illnesses, PANDAS is not understood nor accepted by all medical professionals. Parents often do not receive the same level of support as a result. Many go to see multiple doctors before getting a proper diagnosis. It is my mission as a naturopathic pediatrician to educate parents about this disorder – behaviors to look out for, how to treat it, who can help – so kids can be diagnosed, treated, and feel better immediately.

What are PANDAS and PANS?

Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection (PANDAS), and its later, broader definition, Pediatric Acute-onset Neuropsychiatric Syndrome (PANS), are neuroimmune disorders that are estimated to affect 1 in 200 children. (1)

A child may develop this disorder after having a Streptococcal infection, like strep throat. When it’s clear that your child’s symptoms are related to a strep infection, the disorder is called PANDAS. When it’s caused by another infection, we call it PANS. Non-strep triggers include: walking pneumonia, staph infection, lyme disease, influenza, Epstein-Barr Virus, Herpes Simplex Virus and Coxsaskie virus. It’s believed that these disorders happen because of a problem in the immune system’s response to an infection – it targets the brain instead of germs in the body. (2)

How to Recognize PANS/PANDAS In Your Child

PANDAS is recognized by an acute or severe onset of symptoms. Let’s pause here. What exactly does that mean? Behavior changes happen suddenly and at full intensity. Parents can be at a loss for words when their child develops this disorder – they often have no idea what’s happened to their healthy child overnight. Here are common symptoms of PANS/PANDAS to look out for:

  • OCD
  • Tics
  • Anxiety/Separation Anxiety
  • New and intense fears
  • Sleep issues
  • Bedwetting
  • Depression
  • Irritability
  • Aggressive or hyper behavior
  • New trouble with school
  • Sensitivity to noise, light, or touch

A child with PANDAS and PANS will develop these symptoms suddenly – usually within 24-48 hours. If your child already struggles with a health issue listed above, like tics or OCD, these may suddenly become worse after an infection.

How Does a Naturopathic Doctor Diagnose PANDAS and PANS?

You know your child best, mama. If you feel like something is wrong, and that your child’s change in behavior isn’t just mood swings, bring them in to get a second opinion. It’s best to start treatment right away to have the best possible outcome. A trusted and compassionate health team will also help you feel supported during this difficult time. We diagnose PANDAS and PANS in 2 steps at The Organic Cure:

  1. First, we ask a lot of questions. This is the first step in any visit with us. In this case, we’re looking to see if your child’s experience is in line with the clinical diagnosis for PANDAS/PANS: sudden or severe onset of common symptoms. We look for specific diagnostic criteria.
  2. Next, we test. We conduct blood tests for current and past infections, looking for antibodies and other immune markers that suggest PANS or PANDAS. The tests may include the following:
    • IgE
    • IgA
    • IgM
    • IgG (subclass 1, 2, 3, 4)
    • CBC
    • ANA
    • Ferritin
    • B-12
    • Vitamin D
    • Strep throat culture (48 hour culture or perianal culture)
    • Antistreptolysin O (ASO)
    • Anti dNase B Streptozyme
    • Mycoplasma Pneumoniae IgA & IgM
    • Lyme Disease and co-infections
    • Pneumococcal Antibody Titers
    • Epstein Barr Virus Panel
    • Coxsackie A & B Titers
    • HHV-6 Titers
    • Cunningham Panel

Naturopathic Treatments for PANDAS/PANS

Parenting a child with PANDAS or PANS can feel scary and overwhelming. But you’re NOT alone in this healing journey, mama! And there is hope. Here at The Organic Cure, we use an integrative and individualized approach for treating PANDAS and PANS, so treatment can look different from kiddo to kiddo. Here are a few methods we use: 

  1. Botanical Medicine | Herbs are one of the most reliable tools in a naturopath’s toolbox. Different herbs have different actions. Some are strong antimicrobials, which makes them as effective as antibiotics without harmful side effects to the microbiome. At The Organic Cure, we use careful clinical assessment to determine whether herbs or antibiotics are more appropriate on a case-by-case basis. Lab testing is a crucial part of this decision making process. Other herbs are potent antiinflammatories, and can be used in place of NSAIDS that cause harm to the stomach and liver. Nervines help to relax and restore the nervous system, reducing the dramatic range of symptoms.
  2. Clinical Nutrition | PANDAS/PANS causes inflammation in the body. It’s thus thought to be an auto-immune disease. An anti-inflammatory diet that supports a healthy gut microbiome (and ultimately the brain) is therefore extremely important for kids with PANDAS. Focus on feeding your child…
    • organic whole foods, free from preservatives, additives and GMO’s
    • probiotic and prebiotic foods: yogurt, kefir, sauerkraut, tempeh, banana, apple, asparagus
    • digestive enzymes: onions, garlic, pineapple, papaya, dandelion greens, cinnamon (Work with a health care professional to determine which foods are inflammatory for your child and should be removed from the diet.) When needed, we use supplements to fill in gaps in the nutrition profile. Common supplements we use: 
      • Vitamin D 
      • B-Complex
      • Omega-3
      • Probiotics

You can purchase these supplements that are best for kids at my online dispensary.

3. Nutraceuticals | We often turn to formulations with high-dose vitamins, amino acids, and plant compounds to stimulate healing. High-potency antioxidants like glutathione, alpha-lipoic acid, and COQ-10, for example. They help reduce oxidative stress that occurs when the body is constantly in fight-or-flight mode. These formulations also help ensure the body has what it needs to remove infection and repair damaged systems.

4. Homeopathy | Different homeopathic remedies can be prescribed based on the symptoms being presented. A few that are commonly used for PANDAS/PANS are:

  • Belladonna – helps when detached from reality
  • Secale cornatum – reduces episodes of rage
  • Ignatia – used to treat anxiety
  • Anacardium – helps improve digestion
  • Aconite – helps calm intense, sudden anxiety or fear

*These remedies are best used for symptom management during a flare. Consult with your trusted naturopathic doctor before using these remedies with your little one.

IVIG

IV Immunoglobulin therapy is used to treat other medical conditions like immune deficiencies and encephalitis. It’s currently very difficult to get IVIG coverage for children with PANDAS/PANS. However, oral immunoglobulins are widely available, and can be very helpful.

Cognitive Behavioral Therapy

Kids with PANDAS/PANS, or their parents, may feel traumatized during and after treatment. Talking to a licensed professional may be helpful for you or your child. I recommend choosing a professional who is familiar with PANDAS/PANS.

A Note on Conventional Treatment

Conventional treatment typically includes a series of shot-in-the-dark pharmaceuticals aimed at treating the visible symptoms, since most allopathic professionals do not recognize PANS/PANDAS as a diagnosis. Drugs like antibiotics, corticosteroids, lithium, antidepressants, benzodiazepines, and opiates are commonly used. I don’t have to tell you these will cause more harm, and will not treat the root of the problem.

Naturopathic medicine uses the least invasive and effective methods for healing. If prescription drugs are necessary, they are only used as a temporary tool. You should use whichever method of treatment sits right with you! If you do choose to use prescription medication, note that prolonged use may harm the gut microbiome and immune system, which play a crucial role in your child’s healing. Consult with your trusted pediatrician on how to best support these systems while taking medication. 

There is Hope

You’re doing your best. You’re doing everything you can for your child. Be kind to yourself and know that that is enough. Parenting a child with PANDAS or PANS can feel extremely lonely. I want you to know that you’re not alone. Get a supportive medical team you can trust – your child will get better! If you need a compassionate and dedicated professional in your corner, please schedule a free consult with me. I want to help your family feel better again. We’re on this healing journey together!

RESOURCES:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6462125/

  2. https://kidshealth.org/en/parents/pandas.html

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